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Abstract Stress, unpleasant emotions and autonomic imbalance may play a main role in precipitating
asthmatic attacks. In this study two homogeneous groups of asthmatic patients (N = 24) are treated over an
eight-month period. The experimental group was treated with autogenic therapy and the control group with
supportive group psychotherapy. Respiratory function parameters measured were Forced Vital Capacity
(FVC), Forced Expiratory Volume in the first sec (FEV I), Forced Expiratory Flow between 25% and 75%
of the FVC (FEF25-75%). and Mesoexpiratory Flow (MEF50%). The group under Autogenic Therapy
obtained a relevant clinical improvement (> 15% of pretreatment values) in respiratory function. No
significant changes were observed in the control group. These results suggest that autogenic therapy could
be an effective adjunctive treatment in bronchial asthma.
INTRODUCTION
M. HENRY et al.
METHOD
Subjects
Patients were referred for treatment by the Service of Pneumology of the Department of Internal
Medicine of The University Hospital of the Canary Islands. Selection criteria were as follows:
l. Presence of psychopathological disorders or psychosocial factors associated with the asthmatic
disorder requiring treatment, as well as imperfect control of asthma with conventional medical
treatment.
2. Spirometric evidence of bronchial asthma.
3. Absence of severe disorders in other apparatus and systems.
4. Absence of mental retardation or any other absolute or relative contraindications for autogenic
therapy.
5. Age between 18 and 60 yr (adult patients).
The sample was constituted by a total of 24 patients (21 female and 3 male patients) randomly divided
into two groups of 12 patients (11 females and 1 male in the experimental group vs 10 females and 2
males in the control group).
Patients were chronic asthmatic patients, with a moderate or severe disease, on maximum medical
treatment, i.e. all of them using bronchodilators continuously and inhaled or oral steroids periodically
or continuously. A similar important therapeutical effort was carried out with all these patients.
Patients of both groups were comparable in terms of illness severity, medical treatment regimen and
medical therapy outcome. Chronic asthmatic patients were selected in order to improve their medical
condition, as they had an imperfect control of asthma with conventional medical treatment.
The sample's mean age was 39.66 yr ( 12.09) ranging from 18 to 58 yr. The mean age of the
experimental group was 40.08 yr ( 11.41) ranging from 19 to 55 yr. The controls' mean age was
39.25 yr ( 13.23) ranging from 18 to 58 yr. With respect to age no significant differences were
observed.
Respiratory function assessment
Respiratory function was assessed by Jaeger's Bodyscrecn 11 Pletismographer. In order to evaluate
respiratory function we selected the following parameters, according to Roca et al. [31) :
1. Forced Vital Capacity (FVC);
2. Forced Expiratory Volume in the first second (FEV I );
3. Forced Expiratory Flow between 25% and 75% of the FVC (FEF 25-75%); and
4. Mesoexpiratory Flow (MEF 50%).
Besides these absolute parameters we have also determined relative function parameters in terms of
percentage over the predictable standardized values, according to age, sex and weight.
Treatment
Autogenic therapy, is a psychophysiological psychotherapy relying on periodic self-induction of an
especial consciousness state achieved by passive concentration on formulae with physiological contents
and mental contact with the anatomical regions affected by the formulae. The main elements of the
induction technique are: 1. passive concentration; 2. mental repetition of the autogenic formulae; 3.
mental contact; and 4. stimuli reduction [29].
Conventional supportive group psychotherapy including an educational component focused on
asthmatic symptomatology [32] was used in the control group in order to obviate the attention placebo
effect of the experimental group undergoing a psychological treatment intervention with an extra
attention.
Procedure
After assessing respiratory function patients were randomly assigned to one of the treatment groups.
In the first interview the general purpose and characteristics of the respective treatment were explained
to each patient. After obtaining informed consent, patients began treatment. In the experimental group,
patients were taught the technique and advised to practice the autogenic exercises in three daily 15 min
sessions. Over the eight months treatment period patients met the therapist weekly in 1 hour sessions.
The patients of the control group also met with the therapist in weekly 1 hr sessions over eight months
receiving supportive group psychotherapy including an educational approach.
Data were processed and analysed by using Sigma programme for biostatistical analysis [33]. Comparisons between groups were carried out by applying Student's t-test.
Page 2 of 6
Pretreatment assessment
The results of pretreatment respiratory function assessment appears in Table I.
TABLE I. - RESPIRATORY FUNCTION PARAMETERS. COMPARISON OF
PRETREATMENT VALUES (CONTROL VS EXPERIMENTAL GROUP)
Experimental
FVC
FVC - % PRE
FEV I
FEV I - % PRE
FEF25-75
FEF25-75 - % PRE
MEF50
MEF50 - % PRE
Control
Signif.
SD
SD
2.65
80.5
1.85
67.0
1.66
46.0
1.90
42.3
0.62
14.1
0.57
19.0
0.70
20.1
0.88
20.2
2.59
82.6
1.92
71.9
1.84
50.8
2.13
51.3
0.51
19.1
0.52
23.5
0.85
25.9
1.05
27.2
N.S.
N.S.
N.S.
N.S.
N.S.
N.S.
N.S.
N.S.
The similarity between the mean values of the respiratory parameters of each group
suggests that they are homogeneous, not having introduced any significant change in
the original condition and homogeneity of the sample by its division into two groups.
Post-treatment assessment
The results of post-treatment respiratory function assessment appears in Table II.
TABLE II. - RESPIRATORY FUNCTION PARAMETERS. COMPARISON OF
PRETREATMENT VS POST-TREATMENT VALUES IN THE -EXPERIMENTAL GROUP AND
THE CONTROL GROUP
Group
FVC
% PRE
FEV I
% PRE
FEF25-75
% PRE
MEF50
% PRE
E
C
E
C
E
C
E
C
E
C
E
C
E
C
E
C
PRE
POST
SD
SD
2.65
2.59
80.5
82.6
1.86
1.93
67.0
71.9
1.66
1.84
46.0
50.8
1.90
2.13
42.3.
51.3
0.62
0.51
14.2
19.1
0.57
0.52
19.0
23.5
0.70
0.85
20.0
25.9
0.88
1.05
20.2
27.2
2.96
2.75
94.9
87.2
2.21
2.04
83.3
76.3
2.10
1.85
58.1
52.3
2.31
2.05
55.9
55.2
0.59
0.60
14.2
20.5
0.48
0.42
16.0
21.8
0.66
0.72
19.2
24.5
0.80
0.85
19.7
26.3
DIF (SD)
0.31
0.15
14.3
4.58
0.35
0.11
16.3
4.41
0.44
0.01
12.1
1.50
0.41
-0.07
13.6
3.91
0.24
0.36
8.39
11.0
0.36
0.27
12.4
10.4
0.58
0.41
15.5'
11.9
0.90
0.57
19.9
22.5
Signif
4.55
1.50
5.92
1.43
3.37
1.44
4.56
1.46
2.64
0.09
2.71
0.43
1.60
-0.48
2.35
0.60
***
N.S.
***
N.S.
**
N.S.
***
N.S.
*
N.S.
*
N.S.
N.S.
N.S.
*
N.S.
M. HENRY et al.
DISCUSSION
Page 5 of 6
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